HomeMy WebLinkAbout222 Laporte Ave - Applications/Demolition - 04/21/2011t.F; COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
T16et_Collm 281 N. College Ave. • Fort Collins, CO 80524 Phone: 970-416-2740
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER 1 11 1 o I ds'' APPLICATION DATE 04
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # `7 76 in 7
Last name__..._/ l� C(' k`j" s�Vame Middle /�
Street Address Gi < <7 YI City. ���h State L-t,>` Zip_,*
CONTRACTOR INFO: Company Namea j�Q beg" d f j j�� ���� Contractor Phone #
Lic Holder Name( ✓bb —� I C City of Fort Collins �License # Supervisor Certt #
Mailing Address S 7 CI �
D ) 25-6 1AJZ2CA""-� City uGZ OL State Cr-,e-, Zip �00
LEGAL INFO:
Subdivision/PUD Filing # Lot # /- BI ck # Lot Sq Ft
r•_ntvsttzuETION INFO: Total Building Sq Ft (not induaing basement) Total Garage Sq Ft
Residential Sq Ft Comm9 Sq Ft # of Stories Bldg Height # Dwelling Units
ls' Floor Sq Ft 2"d Floor Sq Ft 3'd Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths % Baths M2 Baths # of Fireplaces
Air Conditioning: YeGo0 Energy info:( Circle appropriate choice) 1. ComCheck [l 2. ResCheck w/Air Sealing 11
3. ResCheck w/Blower Door 11
4. Simulated Performance Alternative[] 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
Water Tap Size
List appropriate option #s
Sewer Tap Size Metered: Yes []No[--] Temp. Pedestal Yes❑ No
Type of Heat: F1Gas ❑Electric
Electric Main Breaker Size (Residential only) Ill50 Amp or Less ❑ 200 Amp 00ther
Contact Name & Phone # of JOBSITE SUPERVISOR: L�c_iY-S 30-�� 33 4i
Subcontractor Info:
Electrical',_
Framer
Solar
Roofing
Other
Mechanical
Concrete
Other
Plumbing
Fireplace
Other
Applicant: I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with all requirements
contained herein and C'�off�rt�Collinsordina ce�and �Iawsregulating building construction. r �/
Applicant gnatur Print Name�l7el ��,� L�r Phone���" 7 ��` 3�%
Distribution: White - Office Yellow -Applicant Pink - WWW/Stormwater